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Objective@#To investigate the role of human papillomavirus (HPV) 16 early genes E2 and E6 and heterogeneous nuclear ribonucleoprotein (hnRNP) E2 and their interaction effects in the progression of the cervical cancer.@*Methods@#Women with normal cervix (NC), low cervical intraepithelial neoplasia (CIN Ⅰ) and high cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ) from the cervical lesions cohort in Jiexiu County of Shanxi Province from June 2014 to September 2014, and patients with cervical squamous cell carcinoma (SCC) treated at the Second Hospital of Shanxi Medical University in the same period were enrolled in this study. There were 257 participants, about 67 NC cases (26.07%), 69 CIN Ⅰ cases (26.85%), 68 CIN Ⅱ/Ⅲ cases (26.46%), and 53 SCC cases (20.62%), respectively. The information of demographic characteristics, life health habits and cervical lesions were collected by using the structured questionnaire. Cervical exfoliated cells and cervical biopsy tissues were collected to detect the infection of HPV16 and the protein expression levels of hnRNP E2, HPV16 E2 and E6. According to the median-value of the protein expression levels of hnRNP E2, HPV16 E2 and E6 and E2/E6 ratio in the NC group, the study participants were divided into the high and low expression groups/ratio groups. The multivariate logistic regression model was used to analyze the correlation between HPV16 early gene E2 and E6, hnRNP E2 and cervical cancer. The interaction effect was analyzed by using the generalized multifactor dimensionality reduction (GMDR) model.@*Results@#The ages of NC, CIN Ⅰ, CIN Ⅱ/Ⅲ and SCC groups were (47.00±9.07), (47.64±7.35), (46.37±8.67) and (51.26±8.03) years old, respectively. The multivariate logistic regression model analysis showed that the HPV16 E2 low expression, E6 high expression and E2/E6 low ratio could increase the risk of CIN Ⅱ/Ⅲ, about OR (95%CI) values 11.11 (1.63-75.56), 8.00 (1.28-50.04), and 9.75 (1.22-77.72), respectively and SCC, about OR (95%CI) values 14.22 (2.11-95.88), 10.33 (1.67-64.00), and 12.38 (1.56-97.91), respectively. The hnRNP E2 low expression could increase the risk of CIN Ⅱ/Ⅲ and SCC, about OR (95%CI) values 3.35 (1.39-8.10) and 5.53 (1.54-19.88). The result of GMDR showed that there were interaction effects of the hnRNP E2 low expression, HPV16 E2 low expression and HPV16 E6 high expression in both CIN Ⅱ/Ⅲ and SCC groups.@*Conclusion@#The HPV16 E2 low expression, HPV16 E6 high expression and hnRNP E2 low expression could increase the risk of high-grade cervical intraepithelial neoplasia and cervical cancer, and they might have an important interaction effect in the progression of the cervical cancer.
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Objective To investigate the effect of heterogeneous nuclear ribonucleoprotein K (hnRNP K) and its interaction with human papillomavims 16 (HPV16) on cervical intraepithelial neoplasia (CIN).Methods The participants included 67 women with normal cervix (NC),69 women with CIN Ⅰ and 68 women with CIN Ⅱ/Ⅲ in a community cohort of pathologically diagnosed women established in Jiexiu of Shanxi province,from June 2014 to June 2015.A structured questionnaire was used to collect the demographic data of the subjects and the related factors of cervical lesions.Cervical exfoliated cells and cervical tissues from biopsy or surgery were selected.The infection status of HPV16 was detected by flow-through hybridization.The protein expression levels of hnRNP K were evaluated by Western blot.SPSS 23.0 software was used to collate and analyze the data.To study the differences in demographic characteristics,related factors,hnRNP K protein and HPV16 infection among NC,CIN Ⅰ and CIN Ⅱ / Ⅲ groups,X2 test,trend x2 test,and Kruskal-Wallis H test were conducted.Multiple comparisons of hnRNP K protein in three groups were completed by using the Bonferroni method.The OR and its 95％CI of hnRNP K,HPV16 and CIN were calculated by using the unconditional logistic regression models.Two-way interactions between hnRNP K protein and HPV16 infection on CIN were analyzed by using additive model and related indicators.Results HPV16 infection rates were 10.4％ in women with normal cervix,14.5％ in women with CIN Ⅰ and 41.2％ in women with CIN Ⅱ/Ⅲ,respectively.The differences among three groups were significant (P＜0.001).Moreover,the infection rates of HPV16 gradually increased with the increasing severity of CIN (trend x2=18.512,P＜0.001).The differences in protein expression of hnRNP K among three groups were significant (H=48.138,P＜0.001) and the expressionincreased with the development of cervical lesionss (trend x2=21.765,P＜0.001).Results from the interaction analysis indicated that there were additive effects between high expression of hnRNP K protein and HPV16 in CIN Ⅱ/Ⅲ group compared with normal group (API=0.639,95％CI:0.083-1.196).In contrast,no such additive effect was found in CIN Ⅰ group.Conclusions HPV16 infection and over-expression of hnRNP K protein were associated with the increased risk of cervical intraepithelial neoplasia.There might be interaction between hnRNP K protein overexpression and HPV16 infection existed on the progress of CIN Ⅰ/Ⅲ.
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Objective To explore the effect of vaginal micro-environment alterations and HPV1 6 infection and their interaction in the progression of cervical intraepithelial neoplasia.Methods The participants of this study came from the cervical lesions study cohort in Shanxi province,including 623 women with normal cervical (NC),303 patients with pathogenically diagnosed low-grade cervical intraepithelial neoplasia (CIN Ⅰ) and 93 patients with pathogenieally diagnosed high-grade cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ).The data of the demographic characteristics of the study subjects and factors related to cervical intraepithelial neoplasia were collected,and HPV16 infection were detected by using flow-through hybridization technology and H2O2,β-glucuronidase,clotting enzyme,neuraminidase and leucocyte esterase in vaginal secretions were detected by using the combined detection kit of aerobic vaginitis and bacterial vaginosis.pH value and vaginal cleanliness were also detected at the same time.The database was established and analyzed by SPSS statistical software (version 22.0).Results The HPV16 infection rate (trend x2=55.45,P＜0.001) and the abnormal rates of H2O2 (trend x2 =26.19,P＜0.001),pH (trend x2=5.06,P=0.024),vaginal cleanliness (trend x2=19.55,P＜0.001),β-glucuronidase (trend x2 =17.52,P＜0.001) and neuraminidase (trend x2 =14.90,P＜ 0.001) increased gradually along with the severity of cervical intraepithelial neoplasia,but the abnormal rates of clotting enzyme and leucocyte esterase showed no same trend.The results of GMDR model analysis showed that there was interaction between HPV16 infection and abnormalities of H2O2,β-glucuronidase,clotting enzyme and neuraminidase in CIN Ⅰ group,and the interaction between HPV16 infection and the abnormalities of vaginal cleanliness,H2O2,β-glucuronidase and neumminidase in CIN Ⅱ/Ⅲ group.Conclusion Our findings indicated that the vaginal micro-environment alterations and HPV1 6 infection could increase the risk of cervical intraepithelial neoplasia,and they might have an important synergistic effect in the progression of cervical intraepithelial neoplasia.
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Objective To evaluate the effects of polycyclic aromatic hydrocarbons (PAHs) and high risk human papillomavirus (HR-HPV) infection and their interaction on the progression of cervical intraepithelial neoplasia.Methods A total of 486 patients,including 208 women with normal cervix (NC),154 patients with low-grade cervical intraepithelial neoplasm (CIN Ⅰ),124 patients with high-grade cervical intraepithelial neoplasm (CIN Ⅱ/Ⅲ),were selected from the cervical lesions cohort from June to December,2014.HR-HPV was detected by using flow-through hybridization technology and the urine concentration of 1-hydroxypyrene (1-OHP) was detected with high performance liquid chromatography.By using software SPSS 22.0,the x2 test,trend x2 test,Kruskal-Wallis H test,Nemenyi rank test and Spearman rank correlation analysis were performed.And the interaction effects were evaluated by additive model.Results The HR-HPV infection rates in NC,CIN Ⅰ and CIN Ⅱ/Ⅲ groups were 27.9％,37.0％ and 58.9％,respectively.The urine concentrations of 1-OHP (pmol/molCr) were 0.07 ± 0.09,0.11 ± 0.10 and 0.17 ± 0.15,respectively.With increasing severity of the cervical lesions,the HR-HPV infection rate gradually increased (trend x2=29.89,P＜0.001) and the high exposure rate of PAHs gradually increased (trendx2 =27.94,P＜0.001).HR-HPV infection was positively correlated with 1-OHP exposure (r=0.680,P＜0.001).There was a positive additive interaction between HPV infection and PAHs exposure in CIN Ⅱ/Ⅲ group,but it was not found in CIN Ⅰ group.Conclusion Both HR-HPV infection and high exposure of PAHs might increase the risk of cervical intraepithelial neoplasm,and might have a synergistic effect on the progression of high-grade cervical intraepithelial neoplasia.
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Objective To investigate the effect of heterogeneous nuclear ribonucleoprotein K (hnRNP K) and its interaction with human papillomavims 16 (HPV16) on cervical intraepithelial neoplasia (CIN).Methods The participants included 67 women with normal cervix (NC),69 women with CIN Ⅰ and 68 women with CIN Ⅱ/Ⅲ in a community cohort of pathologically diagnosed women established in Jiexiu of Shanxi province,from June 2014 to June 2015.A structured questionnaire was used to collect the demographic data of the subjects and the related factors of cervical lesions.Cervical exfoliated cells and cervical tissues from biopsy or surgery were selected.The infection status of HPV16 was detected by flow-through hybridization.The protein expression levels of hnRNP K were evaluated by Western blot.SPSS 23.0 software was used to collate and analyze the data.To study the differences in demographic characteristics,related factors,hnRNP K protein and HPV16 infection among NC,CIN Ⅰ and CIN Ⅱ / Ⅲ groups,X2 test,trend x2 test,and Kruskal-Wallis H test were conducted.Multiple comparisons of hnRNP K protein in three groups were completed by using the Bonferroni method.The OR and its 95％CI of hnRNP K,HPV16 and CIN were calculated by using the unconditional logistic regression models.Two-way interactions between hnRNP K protein and HPV16 infection on CIN were analyzed by using additive model and related indicators.Results HPV16 infection rates were 10.4％ in women with normal cervix,14.5％ in women with CIN Ⅰ and 41.2％ in women with CIN Ⅱ/Ⅲ,respectively.The differences among three groups were significant (P＜0.001).Moreover,the infection rates of HPV16 gradually increased with the increasing severity of CIN (trend x2=18.512,P＜0.001).The differences in protein expression of hnRNP K among three groups were significant (H=48.138,P＜0.001) and the expressionincreased with the development of cervical lesionss (trend x2=21.765,P＜0.001).Results from the interaction analysis indicated that there were additive effects between high expression of hnRNP K protein and HPV16 in CIN Ⅱ/Ⅲ group compared with normal group (API=0.639,95％CI:0.083-1.196).In contrast,no such additive effect was found in CIN Ⅰ group.Conclusions HPV16 infection and over-expression of hnRNP K protein were associated with the increased risk of cervical intraepithelial neoplasia.There might be interaction between hnRNP K protein overexpression and HPV16 infection existed on the progress of CIN Ⅰ/Ⅲ.
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Objective To explore the effect of vaginal micro-environment alterations and HPV1 6 infection and their interaction in the progression of cervical intraepithelial neoplasia.Methods The participants of this study came from the cervical lesions study cohort in Shanxi province,including 623 women with normal cervical (NC),303 patients with pathogenically diagnosed low-grade cervical intraepithelial neoplasia (CIN Ⅰ) and 93 patients with pathogenieally diagnosed high-grade cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ).The data of the demographic characteristics of the study subjects and factors related to cervical intraepithelial neoplasia were collected,and HPV16 infection were detected by using flow-through hybridization technology and H2O2,β-glucuronidase,clotting enzyme,neuraminidase and leucocyte esterase in vaginal secretions were detected by using the combined detection kit of aerobic vaginitis and bacterial vaginosis.pH value and vaginal cleanliness were also detected at the same time.The database was established and analyzed by SPSS statistical software (version 22.0).Results The HPV16 infection rate (trend x2=55.45,P＜0.001) and the abnormal rates of H2O2 (trend x2 =26.19,P＜0.001),pH (trend x2=5.06,P=0.024),vaginal cleanliness (trend x2=19.55,P＜0.001),β-glucuronidase (trend x2 =17.52,P＜0.001) and neuraminidase (trend x2 =14.90,P＜ 0.001) increased gradually along with the severity of cervical intraepithelial neoplasia,but the abnormal rates of clotting enzyme and leucocyte esterase showed no same trend.The results of GMDR model analysis showed that there was interaction between HPV16 infection and abnormalities of H2O2,β-glucuronidase,clotting enzyme and neuraminidase in CIN Ⅰ group,and the interaction between HPV16 infection and the abnormalities of vaginal cleanliness,H2O2,β-glucuronidase and neumminidase in CIN Ⅱ/Ⅲ group.Conclusion Our findings indicated that the vaginal micro-environment alterations and HPV1 6 infection could increase the risk of cervical intraepithelial neoplasia,and they might have an important synergistic effect in the progression of cervical intraepithelial neoplasia.
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Objective To evaluate the effects of polycyclic aromatic hydrocarbons (PAHs) and high risk human papillomavirus (HR-HPV) infection and their interaction on the progression of cervical intraepithelial neoplasia.Methods A total of 486 patients,including 208 women with normal cervix (NC),154 patients with low-grade cervical intraepithelial neoplasm (CIN Ⅰ),124 patients with high-grade cervical intraepithelial neoplasm (CIN Ⅱ/Ⅲ),were selected from the cervical lesions cohort from June to December,2014.HR-HPV was detected by using flow-through hybridization technology and the urine concentration of 1-hydroxypyrene (1-OHP) was detected with high performance liquid chromatography.By using software SPSS 22.0,the x2 test,trend x2 test,Kruskal-Wallis H test,Nemenyi rank test and Spearman rank correlation analysis were performed.And the interaction effects were evaluated by additive model.Results The HR-HPV infection rates in NC,CIN Ⅰ and CIN Ⅱ/Ⅲ groups were 27.9％,37.0％ and 58.9％,respectively.The urine concentrations of 1-OHP (pmol/molCr) were 0.07 ± 0.09,0.11 ± 0.10 and 0.17 ± 0.15,respectively.With increasing severity of the cervical lesions,the HR-HPV infection rate gradually increased (trend x2=29.89,P＜0.001) and the high exposure rate of PAHs gradually increased (trendx2 =27.94,P＜0.001).HR-HPV infection was positively correlated with 1-OHP exposure (r=0.680,P＜0.001).There was a positive additive interaction between HPV infection and PAHs exposure in CIN Ⅱ/Ⅲ group,but it was not found in CIN Ⅰ group.Conclusion Both HR-HPV infection and high exposure of PAHs might increase the risk of cervical intraepithelial neoplasm,and might have a synergistic effect on the progression of high-grade cervical intraepithelial neoplasia.
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Objective To explore the effect of Src on cervical cancer cells through ERK signal transduction pathway.Methods Experimental study was carried out in vitro.Cervical cancer cell lines Hela (HPV-positive) and C33A (HPV-negative) were treated with Src kinase inhibitor PP2.Then,the cell cycle and apoptosis of each group were evaluated by using flow cytometry (FCM).Western blotting and Real-time PCR were used to detect the levels of the expression of ERK 1/2,c-Fos and c-Jun mRNA and protein respectively.The database was established and analyzed with SPSS statistical software (version 20.0).Results After down-regulating Src,the cell proliferation was inhibited and cell apoptosis was induced.The proportions of G0/G 1 stage of Hela and C33A cell in cell cycle increased while G2/M and S stages decreased.Meanwhile,the mRNA levels of ERK 1,ERK 2,c-Fos and c-Jun increased.And the expression levels of ERK 1/2,phosphorylated ERK 1/2 (p-ERK 1/2)and phosphorylated c-Fos (p-c-Fos) protein decreased,while c-Jun and phosphorylated c-Jun (p-c-Jun)protein expression increased.In addtion,the change level of Hela cell,p-ERK 1/2 and c-Fos protein were lower than that of C33A cell before and after the Src inhibition.Conclusions Src,involved in regulating the expression of key factors of the ERK signal transduction pathway including p-ERK 1/2 and p-c-Fos,might be capable of promoting the proliferation of cervical cancer cells and inhibiting their apoptosis.The infection with HPV might have adjustable effect on this process.
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Objective To explore the effect ofpolycyclic aromatic hydrocarbons (PAHs) and p16,FHIT gene CpG island methylation,as well as their interaction in cervical intraepithelial neoplasias.Methods Objects of this study were from a cohort of cervical lesions study in Yangqu county of Shanxi province.All the patients were diagnosed pathologically,that including 83 patients with high-grade cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ),86 patients with low-grade cervical intraepithelial neoplasia (C1N Ⅰ) and another 91 women under normal cervical (NC) condition.1-hydroxy pyrene in the urine was detected by high performance liquid chromatography (HPLC)while CpG island methylation status of tumor suppressor gene p16 and FHIT were measured by methylation-specifc polymerase chain reaction (MSP).Data were analyzed with Kruskal-Wallis H test,chi-square test and trend of chi-square test.Logistic regression models were used to estimate the odds ratio (OR) and corresponding 95％ confidence intervals (95％CI) between influencing factors and the cervical disease by using the SPSS statistical software (version 20.0).The interaction under study was evaluated by using the generalized multifactor dimensionality reduction (GMDR) model.Results Level of 1-hydroxy pyrene (H=50.743,P＜0.001) and the high exposure rate of 1-hydroxy pyrene (trend x2=20.146,P＜0.001) were gradually increasing along with the severity of cervical intraepithelial neoplasia.The CpG island methylation rates ofpl6,FHIT in CIN] and CIN Ⅱ/Ⅲl group were higher than that in NC group,and gradually increasing along with the severity of cervical intraepithelial neoplasia (trend x2=9.75,P=0.002;trend x 2 =10.39,P=0.001).Results from the GMDR model showed that interaction existed among the high exposure of l-hydroxy pyrene and the CpG island methylation ofpl6,FHIT in CIN Ⅰ and CIN Ⅱ]/Ⅲ group.Conclusion Under the high exposure of 1-hydroxy pyrene and the CpG island methylation of p16,FHIT appeared to have increased the risk of cervical intraepithelial neoplasia and causing synergistic effect in cervical intraepithelial neoplasia.
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Objective To explore the effect of Src on cervical cancer cells through ERK signal transduction pathway.Methods Experimental study was carried out in vitro.Cervical cancer cell lines Hela (HPV-positive) and C33A (HPV-negative) were treated with Src kinase inhibitor PP2.Then,the cell cycle and apoptosis of each group were evaluated by using flow cytometry (FCM).Western blotting and Real-time PCR were used to detect the levels of the expression of ERK 1/2,c-Fos and c-Jun mRNA and protein respectively.The database was established and analyzed with SPSS statistical software (version 20.0).Results After down-regulating Src,the cell proliferation was inhibited and cell apoptosis was induced.The proportions of G0/G 1 stage of Hela and C33A cell in cell cycle increased while G2/M and S stages decreased.Meanwhile,the mRNA levels of ERK 1,ERK 2,c-Fos and c-Jun increased.And the expression levels of ERK 1/2,phosphorylated ERK 1/2 (p-ERK 1/2)and phosphorylated c-Fos (p-c-Fos) protein decreased,while c-Jun and phosphorylated c-Jun (p-c-Jun)protein expression increased.In addtion,the change level of Hela cell,p-ERK 1/2 and c-Fos protein were lower than that of C33A cell before and after the Src inhibition.Conclusions Src,involved in regulating the expression of key factors of the ERK signal transduction pathway including p-ERK 1/2 and p-c-Fos,might be capable of promoting the proliferation of cervical cancer cells and inhibiting their apoptosis.The infection with HPV might have adjustable effect on this process.
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Objective To explore the effect ofpolycyclic aromatic hydrocarbons (PAHs) and p16,FHIT gene CpG island methylation,as well as their interaction in cervical intraepithelial neoplasias.Methods Objects of this study were from a cohort of cervical lesions study in Yangqu county of Shanxi province.All the patients were diagnosed pathologically,that including 83 patients with high-grade cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ),86 patients with low-grade cervical intraepithelial neoplasia (C1N Ⅰ) and another 91 women under normal cervical (NC) condition.1-hydroxy pyrene in the urine was detected by high performance liquid chromatography (HPLC)while CpG island methylation status of tumor suppressor gene p16 and FHIT were measured by methylation-specifc polymerase chain reaction (MSP).Data were analyzed with Kruskal-Wallis H test,chi-square test and trend of chi-square test.Logistic regression models were used to estimate the odds ratio (OR) and corresponding 95％ confidence intervals (95％CI) between influencing factors and the cervical disease by using the SPSS statistical software (version 20.0).The interaction under study was evaluated by using the generalized multifactor dimensionality reduction (GMDR) model.Results Level of 1-hydroxy pyrene (H=50.743,P＜0.001) and the high exposure rate of 1-hydroxy pyrene (trend x2=20.146,P＜0.001) were gradually increasing along with the severity of cervical intraepithelial neoplasia.The CpG island methylation rates ofpl6,FHIT in CIN] and CIN Ⅱ/Ⅲl group were higher than that in NC group,and gradually increasing along with the severity of cervical intraepithelial neoplasia (trend x2=9.75,P=0.002;trend x 2 =10.39,P=0.001).Results from the GMDR model showed that interaction existed among the high exposure of l-hydroxy pyrene and the CpG island methylation ofpl6,FHIT in CIN Ⅰ and CIN Ⅱ]/Ⅲ group.Conclusion Under the high exposure of 1-hydroxy pyrene and the CpG island methylation of p16,FHIT appeared to have increased the risk of cervical intraepithelial neoplasia and causing synergistic effect in cervical intraepithelial neoplasia.
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Objective To observe the clinical efficacy of wrist-ankle acupuncture in treating pain due to laparoscopic cholecystectomy.Method Totally 150 patients who were going to receive laparoscopic cholecystectomy were randomized into group A, group B, and group C, 50 cases in each group. Group A was intervened by wrist-ankle acupuncture prior to anesthesia, with the needles retained for 12 h; group B was by subcutaneous needling at the area nearby the points prior to anesthesia, with the needles retained for 12 h; group C didn’t receive any intervention before anesthesia. For the three groups, general inhalational and intravenous anesthesia was adopted for surgery, and patient-controlled intravenous analgesia for post-operation analgesia. The incision pain and visceral pain in the three groups were recorded by using Visual Analogue Scale (VAS) respectively 1 h, 2 h, 4 h, 8 h, 12 h, 24 h, 36 h, and 48 h after the operation. The total effective rate, analgesics consumption after operation, and incidence rate of adverse reaction were compared.Result There were significant differences in comparing the VAS scores of incision pain and visceral pain between group A and group C 4 h, 8 h, 12 h, 24 h, and 36 h after the operation (P<0.01,P<0.05). Between group A and group B, there were significant differences in comparing the VAS score of incision pain 8 h, 12 h, 24 h, and 36 h after the operation and the VAS score of visceral pain 12 h, 24 h, and 36 h after the operation (P<0.05). The total effective rate was 96.0% in group A, which was significantly different from 84.0% in group B and 86.0% in group C (P<0.05). The consumption of Fentaneyl citrate injection was (52.4±10.8)μg in group A, which was significantly different from (92.2±11.0)μg in group B and (107.2±11.5)μg in group C (P<0.05,P<0.01). The incidence rate of adverse reactions was 12.0% in group A, which was significantly different from 58.0% in group B and 66.0% in group C (P<0.01).Conclusion Wrist-ankle acupuncture plus patient-controlled intravenous analgesia can mitigate pain after laparoscopic cholecystectomy, and thus it can be taken as one of the post-operational analgesic approaches.
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Objective To evaluate systematically the long-term efficacy and prognostic factors of surgical treatment for gastric carcinoma with liver metastases (GCLM).Methods Database including Chinese Journal Full Text Database,Wan Fang Database,VIP database,Chinese Database of Literature on Biomedicine,Pubmed,EMBASE,Cochrane Library,Medline,Springerlink and Wiley Online Library were searched with“胃癌,胃月中瘤,肝转移,手术治疗,外科手术,肝切除术,生存率,预后因素,gastric cancer,gastric carcinoma,hepatic,resection,hepatic resection,hepatectomy,liver metastases,hepatic metastases,surgery,surgical,survival,prognostic factors.The time for retrieving was from January 1995 to August 2015.Literatures on longterm efficacy and prognostic factors of radical resection of gastric carcinoma combined with hepatectomy for GCLM were retrieved,and data were analyzed and evaluated by 2 independent researchers.The count data were presented by the relative risk (RR) and 95％ confidence interval (95％ CI).The group rate was merged by the formula RR/(1 + RR),corresponding 95％ CI upper limit values were transferred by the formula RR/(1 + upper limit value RR),and the lower limit values were transferred by the formula RR/(1 + lower limit value RR).The comparison of group rates was done by indirect comparison,Z =difference between group rate/√∑ni=1 (standard error of group rate)2.The heterogeneity was analyzed by I2.Results Eighteen literatures of cross-sectional studies were retrieved and the total sample size was 410 patients.The results of Meta analysis:(1) the summary RR of 3-year overall survival of surgical patients with GCLM was 0.47 (95％ CI:0.37-0.60) while the summary 3-year overall survival rate was 32.0％ (95 ％ CI:0.27-0.38).(2) The summary RR of 5-year overall survival of surgical patients with GCLM was 0.35 (95％ CI:0.27-0.45),summary RR of 5-year overall survival rate was 25.9％ (95％ CI:0.21-0.31).(3)The summary RR of overall recurrence of surgical patients with GCLM was 2.95 (95％CI:2.23-3.88) while the summary overall recurrence rate was 74.7％ (95％CI:0.69-0.80).(4)The summary RR of remnant liver recurrence of surgical patients with GCLM was 1.39 (95％ CI:0.91-2.15) while the summary RR of remnant liver recurrence rate was 58.2％ (95％ CI:0.48-0.68).(5)The summary 3-year survival rate of surgical patients with GCLM and primary carcinoma serosal invasion was 32.9％ (95％ CI:0.23-0.44),and summary 5-year survival rate was 25.9％ (95％ CI:0.16-0.40).The summary 3-year survival rate of surgical patients with GCLM and without primary carcinoma serosal invasion was 47.9％ (95％ CI:0.38-0.58),and summary 5-year survival rate was 38.3％ (95％ CI:0.29-0.49).The summary 3-year survival rate of surgical patients with synchronous hepatic metastases was 30.6％ (95 ％ CI:0.24-0.38),and summary 5-year survival rate was 24.2％ (95％ CI:0.18-0.32).The summary 3-year survival rate of surgical patients with metachronous hepatic metastases was 40.1％ (95％ CI:0.32 0.48),and summary 5-year survival rate was 32.9％ (95％ CI:0.25-0.41).The summary 3-year survival rate of surgical patients with solitary metastatic hepatic carcinoma was 47.6％ (95％ CI:0.40-0.56),and summary 5-year survival rate was 37.1％ (95 ％ CI:0.26-0.48).The summary 3-year survival rate of surgical patients with multiple metastatic hepatic carcinoma was 28.6％ (95％ CI:0.18-0.42),and summary 5-year survival rate was 15.3％ (95％ CI:0.07-0.30).The summary 3-year survival rate of surgical patients with GCLM and R0 resection was 28.6％ (95 ％ CI:0.19-0.40),and summary 5-year survival rate was 20.0％ (95％ CI:0.12-0.32).The summary 3-year survival rate of surgical patients with GCLM and without R0 resection was 0.0,and summary 5-year survival rate was 9.1％ (95 ％ CI:0.03-0.25).The summary 3-year survival rate of surgical patients with GCLM and resection margin ＜ 10 mm was 13.0％ (95 ％ CI:0.05-0.30),and summary 5-year survival rate was 8.3 ％ (95 ％ CI:0.02-0.28).The summary 3-year survival rate of surgical patients with GCLM and resection margin ≥ 10 mm was 34.6％ (95 ％ CI:0.21-0.52),and summary 5-year survival rate was 34.6％ (95％ CI:0.21-0.52).The summary 3-year survival rate of surgical patients with GCLM and chemotherapy was 45.9％ (95％ CI:0.29-0.64),and summary 5-year survival rate was 29.1％ (95 ％ CI:0.19-0.42).The summary 3-year survival rate of surgical patients with GCLM and without chemotherapy was 38.7％ (95 ％ CI:0.26-0.53),and the summary 5-year survival rate was 25.4％ (95％ CI:0.18-0.35).The 3-year survival rate of surgical patients without primary carcinoma serosal invasion and with metachronous hepatic metastases,solitary metastatic hepatic carcinoma,R0 resection and resection margin ≥10 mm was statistically significantly higher than that of surgical patients with primary carcinoma serosal invasion,synchronous hepatic metastases,multiple metastatic hepatic carcinoma and resection margin ＜ 10 mm and without R0 resection (Z =2.118,1.999,3.01 8,5.295,2.183,P ＜ 0.05).The 5-year survival rate of surgical patients with solitary metastatic hepatic carcinoma and resection margin ≥ 10 mm was statistically significantly higher than that of surgical patients with multiple metastatic hepatic carcinoma and resection margin ＜ 10 mm (Z =4.528,2.819,P ＜ 0.05).Conclusion Overall long-term efficacy of surgical patients with GCLM is not good enough,and there is the better prognosis in the surgical patients without primary carcinoma serosal invasion and with metachronous hepatic metastases,solitary metastatic hepatic carcinoma,R0 resection and resection margin≥ 10 mm.
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Objective To investigate the drinking pattern and the condition of alcoholic fatty liver disease in a certain coal mine workers in Shanxi Province.Methods A total of 1501 workers in a coal mine in Shanxi Province were surveyed by field investigation method.Contents include questionnaire, physical measurement, abdominal ultrasound liver and fasting blood glucose, blood lipid, liver function, cholesterol, blood biochemical indicator detection.ALD diagnostic criteria for fatty liver and alcoholic liver disease group were .recommended by the Chinese Medical Association in 2010.The t test,X2 test and multiariable logistic regression analysis were conducted by SPSS17.0 software.Results This study involved ALD patients with 265 people, accounting for 17.65％ of the total survey.The drinking pattern, such as drinking patterns in the initial drinking age,long duration of drinking, drinking frequency, drunkenness, fasting drinking, average daily alcohol intake as the risk factors of alcoholic liver disease.The Logistic regression analysis of alcoholic liver disease related factors showed that, drinking age, drinking way and daily average alcohol intake were closely related to the occurrence of ALD(OR=0.942,P=0.769;OR=2.811,P=0.000;OR=1.756,P=0.000;OR=542.844,P=0.001) .Conclusion In the coal mine workers, drinking pattern in the initial drinking age, drinking age, daily average alcohol intake are closely related to ALD illness.
ABSTRACT
Objective To evaluate the prognosis and safety of long-term oral Branched-Chain Amino Acids (BCAAs) for patients with cirrhosis.Methods Randomized controlled trials (RCTs) were identified from CBM (between January 1978 and September 2013),CNKI (between January 1979 and September 2013),PubMed (between January 1970 and September 2013),EMBASE (between January 1970 and September 2013),and Cochrane Library (issue 4,2013).Publications of the RCTs on the treatment of cirrhosis with oral BCAAS were included and analyzed according to the criteria of Cocbrane handbook.Results Six RCTs involving 1 047 patients were included.The results showed that oral BCAAs improved the event-free survival when compared with the control group [RR =1.13,95％ CI =(1.05,1.23),P =0.001].BCAAs supplements had no effect on mortality or had no definite effect on the deteriorative rate of minimal hepatic encephalopathy (MHE) or quality of life (QOL).As reported in some trials,the main side effects of BCAAs were gastrointestinal symptoms.Conclusions Long-term oral BCAAs may improve event-free survival in cirrhotic patients.However,no definite conclusion can be made without evidences from larger,randomized,double-blind,placebo-controlled,and multicenter trials.